DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193811

Prevalence and determinants of postnatal depression in a tertiary care teaching institute in Kerala, India

Heera Shenoy T., Remash K., Sheela Shenoy T.

Abstract


Background: Pregnancy and childbirth produce a variety of physiological, psychological and social consequences. Attitudes toward pregnancy and childbirth vary from culture to culture. Prevalence estimates range from 13 to 19% in resource-rich settings and 11 to 42% in resource- limited settings PND has a significant impact on the mother, the family, her partner and mother-infant interaction. This research aims to aid the early diagnosis of postnatal depression and the socio-demographic, obstetric, family dynamics, neonatal characteristics and psychiatric determinants of depression using EPDS among postnatal women in a tertiary hospital in Kerala state, India.

Methods: 119 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Diagnosis of depression was made using the Edinburgh postnatal depression scale. Possible depression is values >13 or more are invariably associated with depression.

Results: Young age at marriage (p-value 0.022), love marriage (p-value 0.040) and low social support inadequate relationship with the in-laws was significantly associated with PND (p-0.003). Low birth weight was a significant determinant of PND (p-value-0.018). Gender of the new-born, fear and preference towards any particular gender and order of female child in multiparous woman had no association in determining postnatal depression. Childcare stress (p-value-0.011), psychiatry history in family and personal history of depression and mothers with low self-esteem (p-value-0.001) had odds of developing postnatal depression in the study.

Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes.


Keywords


Edinburgh postnatal depression scale, Gender, Marriage, Postnatal depression, Postnatal mothers, Relationship, Significant

Full Text:

PDF

References


Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-6.

Hara MW, Cabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:18-25.

Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002;347:194-9.

Hegde S, Latha KS, Bhat SM, Sharma PS, Kamath A, Shetty AK. Postpartum depression: prevalence and associated factors among women. Indian J Women Health Issues Care. 2012;1:13-7.

Beck CT. Predictors of postpartum depression. An Update. Nursing Research. 2001;50:275-85.

Rubertsson C, Börjesson K, Berglund A, Josefsson A, Sydsjö G. The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nord J Psychiatry. 2011;65:414-8.

Sword W, Landy KC, Thabane L, Watt S, Krueger P, Farine D, Foster G. Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study? BJOG: Int J Obstet Gynaecol. 2011;118:966-77.

Mccoy SJB, Beal JM, Saunders B, Hill EN, Payton ME, Watson GH. Risk factors for postpartum depression: a retrospective investigation. J Reprod Med. 2008;53(3):166-70.

Chaaya M, Campbell OMR, Kak FE, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinants in Lebanon. Arch Women’s Mental Health. 2002;5(2):65-72.

Gonidakis F, Rabavilas AD, Varsou E, Kreatsas G, and Christodoulou GN. A 6-month study of postpartum depression and related factors in Athens Greece. Comprehens Psychiatr. 2008;49(3):275-82.

Patel V, Rodrigues M, DeSouza M. Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Ame J Psychiatry. 2002;159:43-7.

Shivalli S, Gururaj N. Postnatal Depression among rural women in South India: Do socio-demographic, obstetric and pregnancy outcome have a role to play? PLoS ONE. 2015;10(4):1-11.

Dhande N, Khapre M, Nayak S, Mundey A. Assessment of postnatal depression among mothers following delivery in rural area of Wardha district: A cross sectional study. Innovative Journal of Medical and Health Science. 2014;4:53-5.

Lee D, Yip A, Chiu H, Leung T, Chung T. A psychiatric epidemiological study of postpartum Chinese women. Am J Psychiatry. 2001;158:22-26.

Ghubash R, Saleh MT. Postpartum psychiatric illness in Arab culture: prevalence and psychosocial correlates. Br J Psychiatry. 1997;171:65-8.

Nhiwatiwa S, Patel V, Acuda W. Predicting postnatal mental disorder with a screening questionnaire: a prospective cohort study from Zimbabwe. J Epidemiol Community Health. 1998;52:262-66.

Tannous L, Gigante LP, Fuchs SC, Busnello ED. Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants. BMC Psychiatry. 2008;8:1.

Cooper PJ, Tomlinson M, Swartz L, Woolgar M, Murray L. Postpartum depression and the mother-infant relationship in a South African periurban settlement. Br J Psychiatry. 1999;175:554-8.

Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington R. Mother’s mental health and infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2004;30:21-7.

Dubovsky SL, Buzan R. Mood Disorders. In RE Hales, SC Yudofsky, JA Talbott (Eds.), Textbook of Psychiatry. 3rd ed. Washington, DC: American Psychiatric Press; 1999:479-565

Clarke K, Saville N, Shrestha B, Costello A, King M, Manandhar D. Predictors of psychological distress among postnatal mothers in rural Nepal: a cross-sectional community-based study. J Affective Disorder. 2014;156:76-86.

Kruthika K, Udayar SE, Mallapur MD. An epidemiological study of postnatal depression among women availing maternal health services in rural areas of Belagavi, Karnataka, India. Int J Community Med Public Health. 2017;4:759-63.

Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J. Antenatal risk factors for postnatal depression: a large prospectivestudy. J Affect Disord. 2008;108:147-57.

Troutman BR, Cutrona CE. Nonpsychotic postpartum depression among adolescent mothers. Journal of Abnormal Psychology. 1990;99:69-78.

Siu BW, Leung SS, Ip P, Hung SF, O’Hara MW. Antenatal risk factors for postnatal depression: a prospective study of Chinese women at maternal and child health centres. BMC Psychiatry. 2012;12:22.

Seguin L, Potvin L, Denis M, Loiselle J. Depressive symptoms in the late postpartum among low socioeconomic status women. Birth. 1999;26:157-163.

Chandran M , Tharyan P , Muliyil J, Abraham .Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry. 2002;181:499-50.

Gupta S, Kishore J, Mala YM, Ramji S, Aggarwal R. Postpartum depression in north indian women: prevalence and risk factors. J Obst Gynaecol India. 2013;63(4):223-9.

Suguna A, Naveen R, Surekha A. Postnatal depression among women attending a rural maternity hospital in South India. Ntl J Community Med. 2015;6(3):297-301.

Johnstone SJ, Boyce PM, Hickey AR, Yatees AD, Harris MG. Obstetric risk factors for postnatal depression in urban and rural community samples. Australian New Zealand J Psych. 2001;35:69-74.

Brugha TS, Sharp HM, Cooper SA, Weisender C, Britto D, Shinkwin R. The Leicester 500 Project. Social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychological Medicine. 1998;28:63-79.

Forman DN, Videbech P, Hedegaard M, Salvig JD, Secher NJ. Postpartum depression: identification of women at risk. British J Obst Gynaecol. 2000;107:1210-1217.

Nagandla K, Nalliah S, Yin LK, Majeed ZA, Ismail M, Zubaidah S. Prevalence and associated risk factors of depression, anxiety and stress in pregnancy. Int J Reprod Contracept Obstet Gynecol. 2016;5:2380-8.

Logsdon MC, Birkimer JC, Usui WM. The link of social support and postpartum depressive symptoms in African-American women with low incomes. Am J Matern Child Nurs. 2006;25:262-6.

Warner R, Appleby L, Whitton A, Faragher B. Demographic and obstetric risk factors for postnatal psychiatric morbidity. British J Psych. 1996;168:607-11.

Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C. Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obst Gynecol. 2002;99:223-8.

Boyce PM, Todd AL. Increased risk of postnatal depression after emergency caesarean section. Med J Aust. 1992;157:172-4.